| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,797 |
1,527 |
$91K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,335 |
988 |
$89K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
30 |
26 |
$44K |
| 76830 |
Ultrasound, transvaginal |
283 |
244 |
$28K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
357 |
274 |
$24K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
231 |
163 |
$18K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
130 |
115 |
$15K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
80 |
71 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
93 |
52 |
$4K |
| A4550 |
Surgical trays |
384 |
249 |
$2K |
| 99215 |
Prolong outpt/office vis |
20 |
15 |
$2K |
| 59025 |
Fetal non-stress test |
44 |
25 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
18 |
14 |
$1K |
| 81025 |
|
499 |
341 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
21 |
16 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
46 |
35 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
46 |
35 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
60 |
39 |
$603.80 |
| 87660 |
|
46 |
36 |
$563.68 |
| 87480 |
|
46 |
36 |
$563.68 |
| 87510 |
|
46 |
36 |
$563.68 |
| 36415 |
Collection of venous blood by venipuncture |
115 |
97 |
$185.02 |
| 84443 |
Thyroid stimulating hormone (TSH) |
14 |
13 |
$157.83 |
| 84702 |
|
13 |
12 |
$129.80 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
18 |
16 |
$107.04 |
| 82951 |
|
12 |
12 |
$104.49 |
| 99072 |
|
981 |
717 |
$0.00 |
| 0503F |
|
15 |
15 |
$0.00 |